Story by ROSE SHIMBERG

Jenneth Doria has never forgotten the gifts that her father brought home when she was a girl living in Tondo, an impoverished coastal district in Manila, Philippines.

They weren’t candies or toys or fancy appliances. They couldn’t be quickly devoured, broken from play or rendered useless by rust. They were encyclopedias — heavy, leather-bound volumes that as a set encompassed everything there was to know about the world. They were knowledge itself.

“Ever since we were young,” Doria said in a Zoom interview, “we were ingrained with the power of education.”

Education was what allowed Doria to leave the Phillippines after college for a career as a Registered Nurse in the United States. She was speaking from LAX, on her way back to the Philippines with IHHELPP, an organization she founded to build disaster-resilient infrastructure in her native country. She said her heart has always been in giving back to the people there.

At the age of 53, after raising seven children, she returned to school at the University of Utah to earn her master’s degree in nursing education. She then earned her DNP to share her knowledge with the next generation. And since 2015, she has been a professor in the College of Nursing.

Filipinos have long been a major nursing workforce in the United States. Doria, who initially wanted to study business, was encouraged to pursue nursing by her mother, who knew it meant an opportunity to escape from poverty. The career has allowed her to follow her passion — helping others.

“Culturally, it aligns with our values,” she said. “We take care of our elderly, we take care of our family, it’s kind of ingrained with us. So it comes naturally for a Filipino to become a nurse.”

And despite an unprecedented strain on nurses and a rise in anti-Asian attacks, Doria is hopeful about the future of nursing in this country. She’s not alone: starting in 2020 the College of Nursing has ramped up its efforts to strive for equity among students and faculty alike.

Nurses have been in the spotlight since the coronavirus pandemic began, showcasing the extreme sacrifices they were making on the frontlines. Troubling statistics emerged about Filipino nurses: recent reports found that Filipino Americans represent just 4% of American nurses but accounted for 25% of nurse deaths attributed to COVID-19.

Although there’s no way to be certain of the cause, the disproportionate rate of COVID-19 deaths among Filipino healthcare workers has been attributed to several different factors. TIME reported that foreign-educated nurses are frequently sent to hospitals that have trouble retaining American-born nurses. These are places that are understaffed, underfunded and have limited access to personal protective equipment.

Filipino nurses often work in bedside and critical care units. Dedicated to providing the best possible care for their patients, they’re likely to work long hours and go above and beyond, increasing their risk of exposure to illness.

The pandemic has also led to a dramatic increase in anti-Asian hate crimes nationwide. A 2022 report found that mental health concerns among Asian American frontline workers during the pandemic “were compounded by concurrent anti-Asian racism and violence.”

But despite burnout, a continued rise in anti-Asian hate and a nationwide nursing shortage, Doria is, overwhelmingly, optimistic about the next generation.

“This is what I tell my students,” she said. “There’s been so much burnout now. Because we’ve been really severely impacted by this pandemic. But I tell them, you’ve gotta look beyond the hospital walls. Even if it’s not nursing per se, reach out to other things so that you’re really addressing your well-being. What makes you happy? What gives you joy?”

Doria’s optimism mirrors the outlook of the College of Nursing, which is taking action to address these issues both in the classroom and the workplace. The college is exploring big questions with complex answers. How can it attract more diverse groups of people to nursing? And how can it retain the students and faculty that it already has?

“It feels to me like a constant search,” said Valerie Flattes in a Zoom interview. She was named the associate dean for equity, diversity and inclusion when the position was created in July 2021.

Flattes is in charge of implementing action strategies to recruit and retain a more diverse faculty and student body. She emphasized that many of the issues are systemic and come down to undoing years of bias in the healthcare system. But she, too, is hopeful about the college’s efforts.

“I always approach it from the positive,” Flattes said. “We’re trying to change what we teach our students, how we interact with our students.”

The college is undergoing a full curriculum review to remove bias and discrimination in all forms from its course materials. It now intends to include anti-racist content in every course, with anti-racism training provided for students and faculty alike.

Flattes has been a faculty member since 2001. And although change has been slow, she has seen a profound difference since she started teaching.

“At one point there was me, and there was another Black faculty, and another Asian faculty,” she said. But the numbers keep growing. There are now Asian faculty in every department and the college plans to hire more.

Despite the efforts of the U and other institutions, faculty from minority groups with advanced nursing degrees account for just 16% of full-time appointments. With minority groups making up around a third of Americans, the disparity is clear.

The state’s overwhelming whiteness deters some professorial candidates from coming to Utah, Flattes said. But she’s noticed that many people realize it’s not as bad as they expected.

Doria said she loves working at the University of Utah.

“I invested in a college of nursing because I truly feel that I am valued,” she said. “I am so grateful to work with talented, competent and wonderful colleagues.”

Essential in the mission to recruit more diverse faculty is the need to remove the barriers discouraging diverse students from attending nursing school. A 2007 paper listed some of these: cost, admission criteria heavily hinged on GPA and standardized test scores, internalized bias and lack of representation on admissions committees.

There is a cyclical nature to this quest. Higher enrollment of diverse students in nursing and higher education programs results in increased diversity among nursing faculty. And the more diverse faculty present, the more attractive a college will be for students of color. The American Association of Colleges of Nursing stated that a lack of nursing educators from minority groups could warn potential students of barriers to advancement into faculty positions. A more diverse faculty could have the opposite effect, one of encouragement.

“I appreciate our mission to support a diverse student population,” Doria said. Alongside Flattes, she is a member of the Diversity, Equity, Inclusion and Outreach committee acting to identify and address racial bias in the college’s curriculum, recruitment and hiring processes. For Doria, this pursuit will further the ultimate goal of the profession — helping others.

A nursing workforce that is not only more diverse but also more educated about healthcare’s persistent inequities will provide all patients with a higher standard of care. Even if they don’t pursue formal educator roles, nurses can still teach and inspire the people around them. 

“Our students interact with people in the community, and they can be the best ambassadors for us in encouraging people to apply to nursing,” Flattes said. She recalled doing exactly that when she worked as a nurse and met patients who wished that they’d gone into the field.

Although progress feels slow-moving, Flattes, Doria and their colleagues are hard at work. Anti-racist curriculum, bias training, recruitment strategizing and research are all on the agenda. Flattes believes that the most important thing she can do is keep talking to people and educating them on the importance of these issues.

“There is a long way to go,” she said. “But we’re getting closer every day.”

Filed under: Asian American, Education, Immigrants & Refugees, Medicine, Mental Health |